This invention relates to new macrolide antibiotics with improved activity, to medicaments comprising such antibiotics and to the use of such antibiotics for the treatment of infectious diseases and inflammatory diseases.
Macrolides are an effective and safe class of antibiotics. Among the commonly used macrolides are erythromycin, and the second generation agents clarithromycin and azithromycin. More recently the 3-keto macrolides, the so-called ketolides, have been developed that show improved activity towards macrolide-resistant bacteria.
Ketolides having a five-membered lactone ring fused to the macrolide ring have been disclosed in WO 02/16380, WO 03/072588, WO 02/50091, WO 02/50092, WO 03/024986 and US 2004/0038915. Macrolides having a five-membered lactone ring fused to the macrolide ring and a cladinose sugar attached to the macrolide ring have been disclosed in WO 03/042228 and in WO 03/004509. However, in WO 03/042228, the substitution of the cladinose sugar is different from the substitution of the compounds described hereafter, and in WO 03/004509, no sulfur atom is attached to the five-membered lactone ring.
Furthermore, macrolides have been reported to possess anti-inflammatory activity, and interest in the therapeutic potential of this anti-inflammatory activity has increased recently (e.g. Journal of Antimicrobial Chemotherapy, 1998, 41, Suppl. B, 37-46).
The invention provides new macrolide antibiotics of the following general formula I with improved biological properties:
wherein                R1 is a residue —Y—X-Q;        Y is S, SO or SO2;        X is a bond or a linear group with up to 9 atoms consisting of C, N, O and/or S, of which up to 2 atoms can be N, one atom can be O or S, one carbon atom can appear as a CO group, one sulphur atom can appear as an SO2 group and two adjacent C atoms can be present as —CH═CH— or —C≡C—;        Q is hydrogen, alkyl, heterocyclyl or aryl;        * indicates a chiral centre which is in the (R) or (S) form, i.e. including diastereomeric mixtures and separate stereomeric forms;and pharmaceutically acceptable acid addition salts or in vivo cleavable esters thereof.        
The compounds defined above are new and possess potent antimicrobial properties against Gram-positive and selected Gram-negative organisms. Therefore, they are useful as agents against Gram-positive pathogens such as staphylococci, streptococci, pneumococci and propionibacteria as well as some Gram-negative strains such as H. influenzae and may be used in human or veterinary medicine for treatment or prevention of infections caused by susceptible organisms including those resistant to erythromycin, clindamycin and tetracycline.
In addition to their antimicrobial properties they possess potent anti-inflammatory properties and may be used in human or veterinary medicine for treatment or prevention of inflammation.
As used herein the term “alkyl” refers to straight or branched chain saturated hydrocarbon group having 1 to 12 carbon atoms, preferably 1 to 6 carbon atoms. Such groups are for example methyl, ethyl, n-propyl, isopropyl, tertiary butyl, pentyl, hexyl, and the like. Such alkyl groups may be further substituted with one or more substituents selected from, for example, lower alkoxy such as C1-C4alkoxy like methoxy, ethoxy, propyloxy or n-butoxy, C3-C7cycloalkyloxy or C3-C7cycloalkyl-C1-C4alkoxy like cyclopentyloxy, cyclopropylmethyoxy, halogen such as defined above, halogen substituted alkyl groups such as difluoromethyl or trifluoromethyl, trichloroethyl, cyano, nitro, amino, alkylamino, dialkylamino, alkylthio, mercapto, hydroxy, carbamoyl, a carboxyl group, an oxo group; or aryl or heterocyclyl as defined hereinbelow. The substituents can be identical or different from each other.
The term “halogen” refers to fluorine, chlorine, bromine or iodine.
The term “aryl” refers to aromatic groups with one or more preferably 6-membered aromatic nuclei and having from 6 to 14 carbon atoms. Examples are in particular phenyl, naphthyl, anthryl and phenanthryl. These groups may be further substituted with 1, 2, 3, 4 or 5 substituents selected from, for example, alkyl such as defined above, lower alkoxy such as C1-C4alkoxy like methoxy, ethoxy, propyloxy or n-butoxy, C3-C7cycloalkyloxy or C3-C7cycloalkyl-C1-C4alkoxy like cyclopentyloxy, cyclopropylmethyoxy, halogen such as defined above, halogen substituted alkyl groups such as difluoromethyl or trifluoromethyl, trichloroethyl, cyano, nitro, amino, alkylamino, dialkylamino, alkylthio, mercapto, hydroxy, carbamoyl, a carboxyl group, an oxo group; or aryl or heterocyclyl as defined herein which may be unsubstitued or substituted with one or more of the above identified substituents other than aryl or heterocyclyl. The substituents can be identical or different from each other. In case more than one substituent is attached to the aryl group, these substituents can be identical or different from each other and are also encompassed by the scope of the present invention. For example dimethoxy-phenyl means that both methoxy substituents may be attached to the phenyl ring in the 2,3-position, the 2,4-position, the 2,5-position, the 2,6-position, the 3,4-position, the 3,5-position and the 3,6-position.
Examples of substituted aryl rings are p-methoxy-phenyl, 3,4-dimethoxy-phenyl, 3-cyclopentyloxy-4-methoxy-phenyl, 3-cyclopropylmethyloxy-4-difluoromethyloxy-phenyl, p-dimethylamino-phenyl, p-cyano-phenyl, 5-(dimethylamino)-1-naphthalenyl, 2,4-dimethoxyphenyl, 2′-methoxy-1,1′-biphenyl, 3,4-dimethylphenyl and 1,4-difluorophenyl.
As used herein the term “heterocyclyl” refers to an unsaturated or saturated, unsubstituted or substituted 5- to 10-membered (mono- or bicyclic) heterocyclic ring system containing at least one hetero atom selected from the group consisting of oxygen, nitrogen, and/or sulfur. Exemplary heterocyclic substituents include, but are not limited to, for example, the following groups:
piperidinyl, morpholinyl, 2-, 3- or 4-pyridyl, pyrrolidinyl, piperazinyl, 1H-pyrazol-1-yl, 1H-imidazol-1-yl, 1-H-imidazol-2-yl, pyrazinyl, pyrimidyl, pyridazinyl, pyrazolyl, triazinyl, thiazolyl, thiadiazolyl, oxadiazolyl, triazolyl, e.g. 1H-[1,2,4]-triazol-1-yl, 1H-tetrazolyl, 2H-tetrazolyl; thienyl, furyl (2-furanyl or 3-furanyl), 1H-azepinyl, tetrahydro-thiophenyl, 3H-1,2,3-oxathiazolyl, 1,2,3-oxadiazolyl, 1,2,5-oxadithiolyl, isoxazolyl, isothiazolyl, 4H-1,2,4-oxadiazinyl, 1,2,5-oxathiazinyl, 1,2,3,5-oxathiadiazinyl, 1,3,4-thiadiazepinyl, 1,2,5,6-oxatriazepinyl, 1,6,3,4-dioxadithiopanyl, oxazolidinyl, tetrahydrothienyl, and the like, or condensed heterocyclic ring systems such as quinolinyl, e.g. quinolin-8-yl, quinolin-5-yl, quinolin-2-yl, quinolin-6-yl, quinolin-3-yl, isoquinolinyl (6-isoquinolinyl), quinazolinyl, 1H-benztriazolyl, 1H-imidazo[4,5-c]pyridinyl, 5H-imidazo[4,5-c]pyridinyl, 1H-imidazo[4,5-b]pyridin-1-yl, 3H-imidazo[4,5-b]pyridin-3-yl, 1,2,3,4-tetrahydro-quinolinyl, 1,2,3,4-tetrahydro-isoquinolinyl, thieno[2,3-b]pyridinyl, benzothiazolyl (e.g. 2-benzothiazolyl), 1H-benzoimidazolyl, 1H-indolyl, 1,2,3,4-tetrahydroquinolinyl, purinyl, e.g. 9H-purin-9-yl, 6-amino-9H-purin-9-yl, 2,6-diamino-9H-purin-9-yl, 1H-purin-6-yl, 1H-2,3-dihydroindol-1-yl, 2,1,3-benzoxadiazol-5-yl, 2,1,3-benzoxadiazol-4-yl, 1,3-benzodioxol-5-yl, 6-quinoxalinyl, 2-benzo[b]thien-3-yl, 3,4-dihydro-1H-2-oxo-quinolin-6-yl.
The heterocyclyl groups may be further substituted by one or more substituents. Such substituents include, for example, alkyl groups such as defined above, lower alkoxy such as C1-C4alkoxy like methoxy, ethoxy, propyloxy or n-butoxy, C3-C7cycloalkyloxy or C3-C7cycloalkyl-C1-C4alkoxy like cyclopentyloxy, cyclopropylmethyoxy, halogen such as defined above, halogen substituted alkyl groups such as trifluoromethyl, trichloroethyl, nitro, amino, alkylamino, dialkylamino, alkylthio, mercapto, hydroxy, carbamoyl, a carboxyl group, an oxo group; or aryl or heterocyclyl as defined above which may be unsubstituted or substituted with one or more of the above-identified substituents other than aryl or heterocyclyl. In case more than one substituent is attached to the heterocyclyl group, these substituents can be identical or different from each other and are also encompassed by the scope of the present invention. For example dimethylpyridyl means that both methyl substituents may be attached to the pyridyl in the chemically possible positions. For example both methyl substituents may be attached to the 2-pyridyl in the 3,4-position, the 4,5-position, the 5,6-position, the 3,5-position, the 3,6-position, the and the 4,6-position. Both methyl substituents may be attached to the 3-pyridyl in the 2,4-position, the 2,5-position, the 2,6-position, the 4,5-position, the 4,6-position, the and the 5,6-position. Both methyl substituents may be attached to the 4-pyridyl in the 2,3-position, the 2,5-position, the 2,6-position, and the 3,5-position.
Examples of substituted heterocyclyl groups are 5-(2-pyridinyl)thien-2-yl, 2,4,6-trimethoxy-3-pyridinyl, 5-methyl-3-isoxazolyl, 5-cyanopyridin-2-yl; 6-(1H-imidazol-1-yl)-3-pyridinyl, 6-(1H-pyrazol-1-yl)-3-pyridinyl, 6-bromo-2-methyl-quinazolin-4-yl.
Especially preferred substituents for the heterocyclyl groups are alkyl, alkoxy, oxo, amino, alkylamino, dialkylamino or aryl, wherein alkyl, alkoxy and aryl are as defined hereinabove.
Examples of preferred substituted heterocyclic rings are 1H-pyrimidin-2,4-dione-1-yl, 1H,3H-pyrimidin-2,4-dione-5-methyl-1-yl, 1H-pyrimidin-4-amino-2-one-1-yl, 6-amino-9H-purin-9-yl, 6-dimethylamino-9H-purin-9-yl, 2,6-diamino-9H-purin-9-yl, 6-amino-8-[(3-pyridinylmethyl)amino]-9H-purin-9-yl, 4-phenyl-1H-pyrazol-1-yl, 3-(pyridin-3-yl)-1H-pyrazol-1-yl, 3-(pyridin-4-yl)-1H-pyrazol-1-yl, 3-(pyridin-3-yl)-1H-imidazol-1-yl, 3-(pyridin-4-yl)-1H-imidazol-1-yl, 3-(pyridin-3-yl)-1H-[1,2,4]triazol-1-yl, 3-(pyridin-4-yl)-1H-[1,2,4]triazol-1-yl and 2-oxo-1,2,3,4-tetrahydro-quinolin-6-yl.
In the combinations “heterocyclylalkyl” and “aralkyl” the components “heterocyclyl”, “ar” (aryl) and “alkyl” have the meanings indicated above.
In a specific embodiment of the invention Q can be hydrogen or alkyl as defined above or a group of the following formula
wherein
is a phenyl ring or a x-membered saturated or unsaturated heterocyclo-aliphatic or heteroaromatic ring containing from 2 to (x-1) carbon atoms with x being 5 or 6, and from 1 to 3 hetero atoms selected from the group consisting of nitrogen, oxygen and sulfur, R2 and R3 are independently selected from the group consisting of hydrogen, alkyl such as defined herinabove, lower alkoxy such as C1-C4alkoxy like methoxy, ethoxy, propyloxy or n-butoxy, C3-C7cycloalkyloxy or C3-C7cycloalkyl-C1-C4alkoxy like
cyclopentyloxy, cyclopropylmethyoxy, halogen such as defined above, halogen substituted alkyl groups such as difluoromethyl or trifluoromethyl, trichloroethyl, cyano, nitro, amino, alkylamino, dialkylamino, alkylthio, mercapto, hydroxy, carbamoyl, a carboxyl group, an oxo group; or aryl or heterocyclyl as defined herein which may be unsubstitued or substituted with one or more of the above identified substituents other than aryl or heterocyclyl, or when both substituents R2 and R3 are located at adjacent carbon atoms of the ring
these two substituents can be taken together with said adjacent carbon atoms to form a 5 to 6 membered aromatic or a x-membered saturated or unsaturated heterocycloaliphatic or heteroaromatic ring containing from 2 to (X-1) carbon atoms with x being 5 or 6, and from 1 to 3 hetero atoms selected from the group consisting of nitrogen, oxygen and sulfur, whererin the residue Q can have alltogether one to four substituents of the kind defined above for R2 and R3.
Particularly preferred groups Q are, e.g.:

The symbol X represents a bond; i.e. is “absent”, or is a spacer which is a linear group with up to 9 atoms and defined as above. The linear group with up to 9 atoms may carry additional hydrogen atoms, to saturate a C atom being a methylene group or to saturate a N atom being an amino group. Preferably, this spacer consists of 2 to 5 atoms.
Preferred groups X are:
(CH2)n, (CH2)mOCH2, (CH2)2NCH3(CH2)2, CH2CH2NH, and (CH2)pCOW,
where n and p are 1-3, m is 0-3 and W is absent or O or NH.
Particularly preferred groups X are ethyl and propyl.
Preferred groups Y are:
S, SO2; particularly S.
Combinations of Y and X are:
For Y═S, X is ethyl, propyl, CH2CO, CH2COCH2, CH2CONR, CH2CONRCH2, CH2CONRCH2CH2, CH2CH2CONR, CH2CH2CONRCH2, CH2CH2NR, CH2CH2NRCO, CH2CH2NRSO2, CH2CH2NRCOO, CH2CH2OCH2, CH2SO2NR, CH2SO2NRCH2, CH2CH2OCONR, CH2CH═CH or CH2C≡C;
where R in the above expressions is hydrogen or methyl.
Preferred groups R1 are:

Also preferred are the following groups R1:

Concerning the two chiral centers indicated by * in the general formula I, the preferred configuration for these centers is 3S, 4R.
Preferred compounds of formula I are listed in the following Table 1:
TABLE 1Formula I:I ExampleR11 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
Particularly preferred are the compounds of Examples 1, 4, 11, 13 and 16.
If desired, compounds of formula I can be converted into a pharmaceutically acceptable acid addition salt. The salt formation is effected at room temperature with methods which are known per se and which are familiar to any person skilled in the art. Not only salts with inorganic acids, but also salts with organic acids come into consideration. Hydrochlorides, hydrobromides, sulfates, nitrates, citrates, acetates, trifluoroacetates, maleates, succinates, methanesulphonates, p-toluenesulphonates and the like are examples of such salts.
Further, the compounds can be converted into in vivo cleavable esters, for example into esters with the 2′-hydroxy group of the sugar moiety, such esters are e.g. acetates, pivaloyl esters, tartrates, maleates, succinates, and the like. These esters can be prepared according to methods known in the art, for example by reaction with an appropriate anhydride.
The compounds of the present invention and their pharmaceutically acceptable acid addition salts or in vivo cleavable esters thereof are useful as antibacterial and anti-inflammatory therapeutics. Compounds of formula I possess excellent antibacterial activity against selected pathogenic bacteria such as strains of Staphylococcus aureus and Streptococcus pneumoniae. They can thus be used as medicaments for the treatment of infectious diseases, especially of infections caused by staphylococci such as septicemia, skin and soft tissue infections, deep infections after trauma, surgery, or insertion of foreign material, endocarditis, pneumonia, arthritis, bursitis, and osteomyelitis; or infections caused by streptococci such as septicemia, skin and soft tissue infections, deep infections after trauma, surgery, or insertion of foreign material, endocarditis, tonsillopharyngitis, pneumonia, bronchopneumonia, bronchitis, otitis, sinusitis, and scarlet fever.
Furthermore compounds of formula I possess excellent antibacterial activity against selected bacteria such as strains of Propionibacterium acnes and Propionibacterium granulosum. They can thus be used as medicaments for the treatment of acne.
Furthermore, compounds of formula I can be used as medicaments for the treatment of infections caused by germs such as Moraxella catarrhalis, Haemophilus spp., Neisseria spp., Legionella spp., Mycoplasma spp., Ureaplasma urealyticum, Rickettsia spp., Bartonella spp., Coxiella burnetti, Chlamydia spp., or susceptible strains of Mycobacterium spp., Nocardia spp., and Actinomyces spp.
In addition to the antibacterial activity compounds of formula I possess anti-inflammatory activity, making them particularly useful for the treatment of diseases such as diffuse panbronchiolitis, cystic fibrosis, asthma, chronic obstructive pulmonary disease (COPD), inflammatory bowel diseases, rosacea, arthritis and inflammatory acne. The compounds of the present invention are also useful for the treatment of psoriasis.
The neutrophil granulocyte is a key element of the inflammatory process. The neutrophils migrate to the site of inflammation and can be activated to release toxic products, including proteolytic enzymes such as elastase. The initiation of the neutrophil response is mediated by cell surface receptors for chemoattractants including bacterial products, platelet activating factor, leukotriene B4, and interleukin 8. Elastase is a major secreted product of activated neutrophils and is a major contributor to the destruction of tissue in inflammatory disease. Several bioassays based on the repression of secretion of elastase, have been described and used for the detection of anti-inflammatory products (Johansson, S., Göransson, U., Luijendik T., Backlund, A., Claeson P., Bohlin L. (2002) J. Nat. Prod. 65: 32-41). As exemplified below (example 35), this test is used to show the modulatory activities of the compounds of the present invention against neutrophil granulocytes. The neutrophils are activated by addition of the bacterial product N-formyl methionyl-leucyl-phenylalanine (fMLP) and cytochalasin B, a stimulator of secretion. The amount of elastase secreted is determined by measuring the reaction of elastase with the chromogenic substrate succinyl-alanyl-alanyl-valyl-nitroanilide (SAAVNA), which generates 4-nitroaniline after cleavage by elastase. The reaction is followed by measuring the absorption change at 405 nm.
MIC values for non-anaerobes were obtained by broth microdilution using CAMHB (BBL) according to NCCLS guidelines (National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, 5th ed. Approved standard M7-A6. NCCLS, Wayne, Pa., 2003). Drugs were dissolved in DMSO prior to dispensing into 96-well microtitre plates; the concentration of DMSO in assay wells never exceeded 2% (v/v). CAMHB was supplemented with 5% (v/v) horse serum (Sigma, cat. no. H-1270) in lieu of laked horse blood for cultivation of Streptococcus pneumoniae, and with 5% (v/v) Fildes enrichment (BBL, cat. no. 220810) supernate in lieu of Haemophilus Test Medium and additives for cultivation of Haemophilus influenzae (Pankuch G A, Hoellman D B, Lin G, Bajaksouzian S, Jacobs M R, Appelbaum P C. Activity of HMR 3647 compared to those of five agents against Haemophilus influenzae and Moraxella catarrhalis by MIC determination and time-kill assay. Antimicrob. Agents Chemother. November 1998; 42(11): 3032-4). Activities expressed as the minimal inhibitory concentrations (MICs) (μg/ml) are given in the following Table 3, and the microorganisms used for testing are listed in Table 2 below.
MIC values towards strains of propionibacteria were obtained by broth microdilution using WCB (Anaerobe Broth MIC, Difco) according to NCCLS guidelines (National Committee for Clinical Laboratory Standards. Methods for anti-microbial susceptibility testing of anaerobic bacteria, 5th ed.; approved standard. NCCLS publication no. M11-A5. NCCLS, Wayne, Pa., 2001). Microtitre plates were loaded into 7-L GENbox anaerobic incubation jars (BioMérieux, cat. no. 96 128) fitted with anaerobic atmosphere generators (BioMérieux, cat. no. 96 124) and a Dry Anaerobic Indicator Strip (BBL, cat. no. 271051). Under these conditions, an O2 concentration <0.1% was achieved by 2.5 h, and a CO2 concentration >15% by 24 h. MIC values were read after incubation at 35-37° C. for 48 h (Table 3).
TABLE 2MicroorganismCodeStaphylococcus aureus ATCC 29213AStaphylococcus aureus 1086BEscherichia coli ATCC 25922CStreptococcus pneumoniae 1/1DStreptococcus pneumoniae SL199TEStreptococcus pneumoniae TupeloFHaemophilus influenzae 12214GHaemophilus influenzae QK50HPropionibacterium acnes EG7NSIPropionibacterium acnes SW101TK
TABLE 3MIC (□g/ml)ABCDEFGHIKErythromycin0.5>32>32<=0.06>328420.125>32Telithromycin0.250.25>32<=0.06<=0.060.521<=0.0616Clindamycinndndndndndndndnd<=0.06>32Tetracyclinendndndndndndndnd<=0.0632Ex. 11>=32>=32<=0.060.1250.510.5<=0.061Ex. 228>32<=0.060.50.548<=0.0616EX. 348>320.2528>32160.2516Ex. 41>=3232<=0.060.50.5220.1254Ex. 52>32>32<=0.0681688<=0.0616Ex. 60.5>32>=32<=0.061222<=0.06>32EX. 732>32>322416>32>3228Ex. 81>32>32<=0.061222<=0.0616Ex. 94>32>32<=0.060.251220.1254Ex. 10ndndndndndndndndndndEx. 118>=32>=32<=0.060.125122<=0.062Ex. 1228>32<=0.060.5148<=0.068Ex. 13216>=32<=0.060.1250.2544<=0.062Ex. 14216>32<=0.060.5188<=0.0616Ex. 151>=32>32<=0.061244<=0.0616Ex. 161>32>=32<=0.060.1250.5220.1251Ex. 171>32>32<=0.060.5144<=0.0616Ex. 181>=3232<=0.062422<=0.06>32Ex. 191>32>32<=0.060.5122<=0.064Ex. 201>32>32<=0.060.5111<=0.068Ex. 212>32>32<=0.060.5244<=0.064Ex. 22232>32<=0.068888<=0.0632Ex. 23232>32<=0.062244<=0.0632Ex. 241>=32>32<=0.064888<=0.06>32Ex. 25116>32<=0.0610.544<=0.064Ex. 262>32>320.125>32>32>32160.125>32Ex. 271>32>32<=0.064488<=0.06>32Ex. 28216>320.25448160.1258Ex. 291>3232<=0.064444<=0.06>32nd = not determined
It has also been found that the compounds of the present invention exhibit substantial inhibitory activity towards human phosphodiesterases (PDEs), in particular towards PDE3 and especially PDE4, which have been shown to be involved in inflammatory processes (cf. e.g. Lipworth B. J., Lancet (2005) 365, p. 167 or Giembycz M. A., Curr. Opin. Pharmacol. (2005), 5, p. 238). This is shown in Examples 36 and 37 below, for the first time for a macrolide derivative like an erythromycin derivative. The use of the compounds of such macrolide derivatives, in particular of compounds according to the present invention for the treatment of diseases and disorders in humans which can be ameliorated or relieved by inhibition of human phodiesterases, in particular phosphodiesterase 3 and 4 (including inflammatory diseases as mentioned above) is therefore a further aspect of the present invention.
The compounds in accordance with the invention can be used as medicaments. They possess good oral absorption properties. A further embodiment of the present invention are thus medicaments comprising compounds of formula I, their pharmaceutically acceptable acid addition salts or in vivo cleavable esters thereof for the treatment and prevention of infectious diseases, for example, in the form of pharmaceutical preparations for enteral (oral) administration. The products in accordance with the invention can be administered, for example, perorally, such as in the form of tablets, film coated tablets, sugar coated tablets, hard and soft capsules, solutions, emulsions or suspensions, or rectally, such as in the form of suppositories, or parenterally e.g. by injection, or nasally, or by inhalation or transdermally, or locally for example by topical administration, preferably the compounds are administered topically or orally.
Pharmaceutical compositions containing these compounds can be prepared using conventional procedures familiar to those skilled in the art, such as by combining the ingredients into a dosage form together with suitable, non-toxic, inert, therapeutically compatible solid or liquid carrier materials and, if desired, the usual pharmaceutical adjuvants.
It is contemplated that the compounds are ultimately embodied into compositions of suitable oral, parenteral or topical dosage forms. The compositions of this invention can contain, as optional ingredients, any of the various adjuvants which are used ordinarily in the production of pharmaceutical preparations. Thus, for example, in formulating the present compositions into the desired oral dosage forms, one may use, as optional ingredients, fillers, such as microcrystalline cellulose, calcium phosphate or lactose; disintegrating agents, such as starch, crosslinked carboxymethylcellulose sodium or crosslinked polyvinylpyrrolidone; and lubricating agents, such as talc, magnesium stearate, calcium stearate, and the like. It should be fully understood, however, that the optional ingredients herein named are given by way of example only and that the invention is not restricted to the use hereof. Other such adjuvants, which are well known in the art, can be employed in carrying out this invention.
Suitable as such carrier materials are not only inorganic, but also organic carrier materials. Thus, for tablets, film coated tablets, sugar coated tablets and hard capsules there can be used, for example, lactose, maize starch or derivatives thereof, talc, stearic acid or its salts. Suitable carriers for soft capsules are, for example, vegetable oils, waxes, fats and semi-solid and liquid polyols (depending on the nature of the active substance). Suitable carrier materials for the preparation of solutions and syrups are, for example, water, alcohols, polyols, saccharose, invert sugar and glucose. Suitable carrier materials for suppositories are, for example, natural or hardened oils, waxes, fats and semi-liquid or liquid polyols.
As pharmaceutical adjuvants there are contemplated the usual preservatives, solubilizers, stabilizers, wetting agents, emulsifiers, sweeteners, colorants, flavoring agents, salts for adjusting the osmotic pressure, buffers, coating agents and antioxidants.
The compounds of formula I and their acid addition salts or in vivo cleavable esters thereof can be used for parenteral administration and for this purpose are preferably made into preparations for injection as lyophilisates or dry powders for dilution with customary agents, such as water or isotonic common salt solution.
The compounds of formula I and their acid addition salts or in vivo cleavable esters thereof can be used for topical administration and for this purpose are preferably made into preparations as ointments, creams or gels.
For the prevention and treatment of infectious diseases and/or inflammatory diseases in mammals, human and non-human, a daily dosage of about 10 mg to about 2000 mg, especially about 50 mg to about 1000 mg, is usual, with those of ordinary skill in the art appreciating that the dosage will depend also upon the age, conditions of the mammals, and the kind of diseases being prevented or treated. The daily dosage can be administered in a single dose or can be divided over several doses. An average single dose of about 100 mg, 250 mg, 500 mg and 1000 mg can be contemplated.
The reaction steps starting from known compounds leading to the end products of formula I are carried out according to schemes 1-3 below.

Compounds of the present invention can be prepared starting from clarithromycin. The preparation of compounds of formula II, III and IV wherein Rp1 and Rp2 are H, acetyl, benzoyl or any other suitable hydroxyl protecting group can be prepared by methods well known in the art (scheme 1). To obtain compounds of formula II wherein Rp1 and Rp2 are as defined above the 2′- and 4″-hydroxyl groups of commercially available clarithromycin can be protected either sequentially or simultaneously by reaction with a suitable acid anhydride or acid chloride as described in, for example, Baker et al., J. Org. Chem. 1988, 53, 2340-2345 and Kashimura et al., J. Antibiotics, 2001, 54, 664-678. Compounds of formula II can then for example be transformed into compounds of formula IV in a similar way as described in Baker et al., J. Org. Chem. 1988, 53, 2340-2345.
The hydroxy group at position 12 of compounds of formula IV is esterified by treatment with 2-chloro acetic acid, DCC and DMAP or with 2-chloro acetic anhydride, pyridine, DMAP in a chlorinated solvent such as methylene chloride. The intermediate V is then treated with the appropriate nucleophile R1H in acetone in the presence of a base such as DBU to give compounds of formula VI wherein R1, Rp1 and Rp2 are as defined above. Depending on the nature of R1 compounds of formula VI can also be synthesised by reacting compound of formula IV with an appropriate carboxylic acid (R1CH2COOH), DCC and DMAP in a chlorinated solvent such as methylene chloride to give compounds of formula VI. Compounds of formula VI are treated with an alkali metal base such as NaH or potassium tert.-butoxide or LDA in an aprotic solvent such as DMF or THF to give compounds of formula VII as mixture of diastereoisomers in various ratios (scheme 1).
Compounds of formula VII wherein R1, Rp1 and Rp2 are as defined above are deprotected at the 2′-position with methanol at temperatures ranging from 20° C. to 60° C. during 2-5 days to give compounds of formula VIII (scheme 2). The 4″-hydroxyl group is deprotected by treatment of the compound with DBU in refluxing methanol for 3 to 12 hours (J. Antibiotics, 2001, 54(8), 664) or by treatment with guanidine/guanidinium nitrate in methanol/dichloromethane (Tetrahedron Letters 1997, 38(9), 1627) or with potassium carbonate in methanol or with a mixture of MeONa in methanol, preferably with DBU in refluxing methanol for 5 to 7 hours to give compounds of formula VIII.
Alternatively compounds of formula VII can be deprotected at the 2′- and the 4″-position simultaneously using one of the methods described above for the deprotection of the 4″-hydroxyl group to give compounds of formula I (scheme 2).

In the case where R1 is S-Rp3 and Rp3 is a sulphur protecting group e.g. benzyl, 4-methoxybenzyl, 3,4-dimethoxybenzyl or 4-nitro-benzyl, preferably 4-methoxybenzyl the intermediate VIIa is transformed in the presence of molecular sieves into disulfide derivative IX wherein Rp1 and Rp2 are as defined above and Rp4 is e.g. 3-nitro-2-pyridinyl or methyl similar to the method described in WO03/072588.
Compounds of formula IX are treated with a reducing agent such as a trialkyl phosphine, preferably tributyl phosphine, or a triaryl phosphine, preferably triphenyl phosphine, in a solvent such as aqueous acetone, aqueous dimethyl formamide, aqueous dioxane or aqueous tetrahydrofuran, preferably aqueous dimethyl formamide, at 0° C. to 60° C., preferably at room temperature for 1 minute to 1 hour, preferably 15 minutes, to give compound X. Compound X is treated, preferably without isolation, directly in the same solvent system with compounds of the formula Q-X-Lg, in which Q and X are defined as before and Lg is a leaving group, e.g. chloride, bromide, iodide, methanesulfonyloxy, p-tosylsulfonyloxy, trifluormethansulfonyloxy or a vinyl group in the case where X represents a carbonyl or a sulfonyl group to give compounds of formula VII. The reaction is preferably effected in the presence of a base such as alkali metal carbonate or hydrogen carbonate, e.g. potassium carbonate, cesium carbonate or sodium hydrogen carbonate, or an organic base, e.g. triethylamine, N-ethyl N,N-diisopropylamine, 1,8-diazabicyclo[5.4.0]undec-7-ene or 1,5-diazabicyclo[4.3.0]non-5-ene, preferably 1,8-diazabicyclo[5.4.0]undec-7-ene at temperature between 0° C. and 50° C., preferably at 20° C. It can be advantageous to add catalytic amounts of an iodide salt, preferably sodium iodide, to the reaction mixture.

The following examples are given to further illustrate the invention and are not to be construed as in any way limiting the scope of the present invention.
General remarks: MS spectra were measured using (A) a Micromass Waters ZQ system with Masslynx software and (B) using a Q-Tof-Ultima (Waters AG) equipped with the Waters Cap-LC. For accurate mass determination the nano lock mass ESI source was used. Accurate masses are given with four decimal digits. HPLC purification of final products was done using the following system: Column: YMC ODS-AQ, 120A, 5 μm, 50×20 mm; precolumn: YMC ODS-AQ, 120A, 5 μm, 10×20 mm; flow: 30 ml/min; injection: 500 μl; detection: ELSD; mobile phase A: water+0.1% HCOOH; mobile phase B: acetonitrile; gradient: linear form 10 to 95% acetonitrile in 4 min. Abbreviations: HPLC for high performance liquid chromatography; DMSO for dimethylsulphoxide; DBU for diazabicycloundecane; DCM for dichloromethane; DIPEA for diisopropylethylamine (Huenig's base); DMF for dimethylformamide; THF for tetrahydrofurane; DCC for dicyclohexylcarbodiimide; DMAP for 4-dimethylaminopyridine; EDC.HCl for N-(3-dimethylaminopropyl)-N′-ethylcarbodiimide hydrochloride; mCPBA for m-Chloroperbenzoic acid; KOtBu for potassium tert.-butylate; MS for mass spectrometry; NMR for nuclear magnetic resonance; ISP for ion spray.